Tracy Mroz, PhD
WWAMI Rural Health Research Center
Phone: 206.598.5396
Email: tmroz@uw.edu
Department of Rehabilitation Medicine
University of Washington
1959 NE Pacific Street
Box 356490
Seattle, WA 98195
- Current Projects - (2)
- Completed Projects - (6)
- Publications - (8)
Current Projects - (2)
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Availability, Care Practices, and Quality of Hospice Providers Serving Rural versus Urban Communities
This project will examine differences in availability of hospice care in rural versus urban communities as well as provider-level quality and care practices by rural-urban status of hospices. Findings will highlight potential rural-urban disparities in hospice care that can be used to inform future Medicare policy.
Research center: WWAMI Rural Health Research Center
Topics: Aging, Coronavirus Disease 2019 (COVID-19), Health disparities and health equity, Health services, Healthcare access, Hospice and palliative care, Medicare, Quality
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Comparing Utilization and Quality of Home Health Care Between Medicare Fee-for-Service and Medicare Advantage Beneficiaries by Rural-Urban Status
This project examines differences in home health use and quality by enrollment in Medicare Fee-for-Service (FFS) versus Medicare Advantage (MA) plans. Findings will include information on rural-urban and intra-rural variation in home health care to inform policies on access, payment, and quality for Medicare FFS and MA plans.
Research center: WWAMI Rural Health Research Center
Topics: Aging, Allied health professionals, Health disparities and health equity, Health services, Healthcare access, Healthcare financing, Home health, Medicare, Medicare Advantage (MA), Post-acute care, Quality
Completed Projects - (6)
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Assessing Potential Unmet Need for Home Healthcare in Rural Areas
This study estimated potential unmet need for home healthcare in rural areas for fee-for-service Medicare beneficiaries. We compared rates of home healthcare utilization in rural areas with urban areas, accounting for acute hospital discharges and utilization of inpatient rehabilitation facilities and skilled nursing facilities.
Research center: WWAMI Rural Health Research Center
Topics: Health services, Home health, Hospitals and clinics, Medicare, Post-acute care
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Diverging Populations Served by the Medicare Home Health Benefit: Comparison of Post-acute vs. Community-entry Home Health in Rural Areas
This study examined differences between rural, fee-for-service Medicare beneficiaries who were admitted to home health from the community (community-entry) and those who were admitted to home health following an inpatient stay (post-acute) in terms of their clinical and non-clinical characteristics as well as the communities in which they live.
Research center: WWAMI Rural Health Research Center
Topics: Health services, Home health, Medicare, Post-acute care
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Examining the Potential Impact of Multiple Payment Policies on Rural Versus Urban Home Health Agencies
This study estimated the impact of three recent and upcoming Medicare home health payment policies (revised rural add-on payments, new prospective payment system, and value-based purchasing demonstration) on reimbursement for home health agencies based on rural-urban status, community factors, and home health agency characteristics.
Research center: WWAMI Rural Health Research Center
Topics: Health services, Healthcare access, Healthcare financing, Home health, Medicare, Post-acute care
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Post-acute Care Quality for Rural Medicare Beneficiaries
This study examined rural post-acute care quality for rural Medicare beneficiaries and potential disparities in post-acute care between urban and rural providers. Publicly reported quality measures for rural skilled nursing facilities and home health agencies were compared with state and national averages as well as urban providers.
Research center: WWAMI Rural Health Research Center
Topics: Home health, Post-acute care
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Post-acute Care Trajectories for Rural Medicare Beneficiaries
Utilization and costs of post-acute care for Medicare fee-for-service beneficiaries have grown rapidly during the last decade. This study examined post-acute care utilization for rural Medicare beneficiaries following acute hospitalization, describing use of home health and skilled nursing care and trajectories of care across settings.
Research center: WWAMI Rural Health Research Center
Topics: Aging, Allied health professionals, Health services, Home health, Hospitals and clinics, Medicare, Nurses and nurse practitioners, Post-acute care
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Use of Home Health Services Among High Risk Rural Medicare Patients: Patient, Service, and Community Factors Associated with Hospital Readmission
This study will examine the 60-day post-acute care outcomes of rural Medicare patients who were discharged from hospitals and admitted to home healthcare services. Key predictors include home health services provided, type of Medicare home health reimbursement, and available community healthcare resources.
Research center: WWAMI Rural Health Research Center
Topics: Home health, Hospitals and clinics, Medicare, Post-acute care
Publications - (8)
2024
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Estimated Impacts of Multiple Payment Policies on Rural-Serving Home Health Agencies
Policy Brief
WWAMI Rural Health Research Center
Date: 07/2024
This brief examines the estimated impact of three Medicare payment policy changes on home health agency (HHA) reimbursement by rural-serving status, geographic location, and select HHA characteristics.
2022
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Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of home health agencies (HHAs) by rural-serving status. While quality of patient care star ratings were not associated with rural-serving status, rural HHAs and urban HHAs that serve rural patients had higher patient experience star ratings than urban HHAs that do not serve rural patients. -
Quality of Skilled Nursing Facilities Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of skilled nursing facilities (SNFs) by rural-serving status. While overall star ratings and staffing star ratings were not associated with rural-serving status, rural SNFs and urban SNFs that serve rural patients had lower quality star ratings compared to urban SNFs that do not serve rural patients.
2021
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Post-acute Care Trajectories for Rural Medicare Beneficiaries: Planned Versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies
Policy Brief
WWAMI Rural Health Research Center
Date: 03/2021
This policy brief describes trajectories for rural Medicare beneficiaries following hospital discharge, including differences between planned and actual discharge to skilled nursing facilities and home health agencies. More than 40% of beneficiaries for whom home health care was indicated did not receive care from a home health agency.
2020
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Variation in Use of Home Health Care Among Fee-for-Service Medicare Beneficiaries by Rural-Urban Status and Geographic Region: Assessing the Potential for Unmet Need
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2020
This study describes use of home healthcare by rural-urban status and geographic region. Findings suggest geographic region drives variation more than rural-urban status. Unmet need may be highest in the most remote rural counties and rural counties within the West North Central, East North Central, Mountain, and Pacific Census Divisions.
2019
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Differences in Care Processes Between Community-Entry Versus Post-Acute Home Health for Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 04/2019
This study describes home healthcare processes for rural Medicare beneficiaries who are admitted from the community (community-entry) versus those who are admitted following an inpatient stay (post-acute). Care processes include timely initiation of care, length of stay, and services provided (e.g., physical therapy, medical social work).
2018
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Different Populations Served by the Medicare Home Health Benefit: Comparison of Post-Acute Versus Community-Entry Home Health in Rural Areas
Policy Brief
WWAMI Rural Health Research Center
Date: 07/2018
This study describes differences between rural, fee-for-service Medicare beneficiaries who are admitted to home health from the community (community-entry) and those who are admitted to home health following an inpatient stay (post-acute) in terms of their clinical and non-clinical characteristics as well as the communities in which they live. -
Service Provision and Quality Outcomes in Home Health for Rural Medicare Beneficiaries at High Risk for Unplanned Care
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study examined service provision and quality outcomes among rural Medicare beneficiaries who used home health from 2011-2013 and were at high risk for unplanned care. More skilled nursing visits and visits by more types of providers were associated with higher hospital readmission and emergency department use and lower community discharge.